Interventions for Family Members and Carers of Patients with Borderline Personality Disorder: A Systematic Review

Carers of patients with borderline personality disorder (BPD) experience high levels of distress. Several studies have been carried out on interventions designed to decrease their burden. However, the evidence from these studies has not been summarized. The objective of this work is to explore the clinical utility of interventions developed for family members of patients with BPD. A systematic review was conducted following the PRISMA guidelines (registration number CRD42018107318), including psychological interventions focused on relatives of patients with BPD. The following databases were used: PsycINFO, PubMed, EBSCOhost, and Web of Science. Two independent researchers reviewed the studies to determine whether the eligibility criteria were met. A total of 2,303 abstracts were identified. After duplicates had been removed, 1,746 studies were screened. Finally, 433 full‐text articles were reviewed, yielding 11 studies that satisfied the inclusion criteria. Results show that these interventions with different clinical formats and settings are effective. The quality of the included studies varies, and the empirical support for these programs is still preliminary. The results help to establish a general framework for interventions specifically developed for family members of patients with BPD, but additional efforts should be made to improve the methodological quality of this field of research and more solidly determine the utility of these interventions. Given the paucity of data so far, this information may open up new lines of research to improve the effectiveness of future programs for carers of patients with BPD and help to reduce their burden.     

Do observers like curvature or do they dislike angularity?

Humans have a preference for curved over angular shapes, an effect noted by artists as well as scientists. It may be that people like smooth curves or that people dislike angles, or both. We investigated this phenomenon in four experiments. Using abstract shapes differing in type of contour (angular vs. curved) and complexity, Experiment 1 confirmed a preference for curvature not linked to perceived complexity. Experiment 2 tested whether the effect was modulated by distance. If angular shapes are associated with a threat, the effect may be stronger when they are presented within peripersonal space. This hypothesis was not supported. Experiment 3 tested whether preference for curves occurs when curved lines are compared to straight lines without angles. Sets of coloured lines (angular vs. curved vs. straight) were seen through a circular or square aperture. Curved lines were liked more than either angular or straight lines. Therefore, angles are not necessary to generate a preference for curved shapes. Finally, Experiment 4 used an implicit measure of preference, the manikin task, to measure approach/avoidance behaviour. Results did not confirm a pattern of avoidance for angularity but only a pattern of approach for curvature. Our experiments suggest that the threat association hypothesis cannot fully explain the curvature effect and that curved shapes are, per se, visually pleasant.     

A Review of Behavioral Interventions for Anxiety‐Related Behaviors in Lower‐Functioning Individuals with Autism

Anxiety is highly prevalent in persons with autism and affects individuals with higher‐functioning autism (HFA) and lower‐functioning autism (LFA). Although there is emerging support for the efficacy of cognitive‐behavioral therapy (CBT) in treating anxiety in autism, these findings are largely based on HFA samples. Moreover, CBT may be inappropriate for individuals with LFA who may struggle to grasp the cognitive components of the therapy because of their more limited verbal abilities. Behavior analytic interventions may be better suited to treat anxiety in this population; however, the quantity and quality of the extant literature have yet to be reviewed. Toward this end, the extant behavioral intervention literature was reviewed. Seven studies met the inclusion criteria and were evaluated against quality indicators for within‐subject design research. Next, the efficacy of each treatment component was assessed using established criteria for defining empirically supported therapies. Results revealed behavioral interventions to be efficacious, with desensitization and reinforcement emerging as efficacious treatment components, while prompting, modeling, and antianxiety stimuli were established as possibly efficacious. However, given that some of the quality indicators were not met, these results should be interpreted with some caution. Additional research is needed to form a more conclusive evidence base for the treatment of anxiety in individuals with LFA. Copyright © 2016 John Wiley & Sons, Ltd.     

Gesturing during mental problem solving reduces eye movements,especially for individuals with lower visual working memory capacity

Non-communicative hand gestures have been found to benefit problem-solving performance. These gestures seem to compensate for limited internal cognitive capacities, such as visual working memory capacity. Yet, it is not clear how gestures might perform this cognitive function. One hypothesis is that gesturing is a means to spatially index mental simulations, thereby reducing the need for visually projecting the mental simulation onto the visual presentation of the task. If that hypothesis is correct, less eye movements should be made when participants gesture during problem solving than when they do not gesture. We therefore used mobile eye tracking to investigate the effect of co-thought gesturing and visual working memory capacity on eye movements during mental solving of the Tower of Hanoi problem. Results revealed that gesturing indeed reduced the number of eye movements (lower saccade counts), especially for participants with a relatively lower visual working memory capacity. Subsequent problem-solving performance was not affected by having (not) gestured during the mental solving phase. The current findings suggest that our understanding of gestures in problem solving could be improved by taking into account eye movements during gesturing.     

Field dependence-independence (FDI) cognitive style: an analysis of attentional functioning

Previous research has indicated that field-dependent children display poorer performance than field-independent children in almost all academic subjects and cognitive tasks. However, the processes underlying this poorer performance remain unclear. The present study aimed to assess whether children with different FDI cognitive styles show differences in performance of tasks measuring aspects of attentional functioning. Specifically, 149 children aged 8 - 11 years were classified according to FDI cognitive style (field-dependent, intermediate, or field-independent), and to storage capacity (Digits Forward Test), verbal working memory (Digits Backward Test), capacity to focus, shift, and maintain attention (Digit Symbol Test), and capacity for sustained attention (Visual Search and Attention Test). Field-independent children displayed better performance than intermediate and field-dependent children on all tests except the Digits Forward Test. Theoretical and practical implications of these results are discussed.     

A link between role of two prefrontal areas in immediate memory and in long-term memory consolidation

The dorsolateral and medial prefrontal cortex are critical for immediate memory processing. The possibility has been raised that those two areas may also contribute to long-term memory formation. Here, we studied the role of specific receptors in dorsolateral and medial prefrontal cortex in immediate and in long-term memory formation of one-trial inhibitory avoidance. Four different specific receptor ligands were infused into these two areas: the dopamine D1 receptor antagonist, SCH23390, the GABA(A) receptor agonist, muscimol, the AMPA glutamatergic receptor antagonist, ciano-nitro-quinoxaline-dione (CNQX), and the NMDA glutamatergic receptor antagonist, aminophosphonovaleric acid (AP5). In all cases the doses used had been previously shown to affect immediate or long-term memory. In the experiments on immediate memory the drugs were given 5 min before training and the animals were tested 3s post-training. These animals were then also tested 24h later for long-term memory. The effect of the treatments on long-term memory was studied by their infusion 0, 90, 180 or 270 min post-training, testing the animals 24h after training. Immediate memory was inhibited by SCH23390, muscimol and CNQX, but not by AP5, given into any of the two subregions. Long-term memory formation was inhibited by SCH23390, muscimol and CNQX, but not by AP5, given pre-training or 0, 90 or 180 but not 270 min post-training into the dorsolateral region; or 90 but not 0 or 180 min post-training into the medial region. Thus, there is a time- and receptor-dependent correlation in the two areas between their role in immediate and in long-term memory processing. Both roles require intact glutamate AMPA and dopamine D1 receptors, are inhibited by GABAergic synapses, and are unaffected by AP5. In the dorsolateral prefrontal cortex the link between immediate and long-term memory appears to be direct; in the medial area the link suffers a 90 min delay.     

An integrated device to evaluate a driver’s functional state

In the field of cognitive ergonomics, research on car drivers requires multimodal in-vehicle systems for recording not only driving-related behavior, but also contextual information from their surroundings. In addition, reliable information concerning a driver’s functional state should be obtained. In this article, we describe an integrated device simultaneously recording specific physiological data, video recordings of the driver and environment, parameters from the vehicle, and contextual data. Physiological signals from the autonomic nervous system provide objective and quantitative information on the driver’s alertness and his/her ability to process specific driving-related stimuli or other nonspecific information. Consequently, recorded physiological responses can be related to individual driving events. Electrodermal and cardiac activities are sensitive to time-dependent variations in arousal level and to certain external stimuli, so there is great interest in studying drivers’ behavior via measured physiological signals that have been established as suitable behavioral indicators. The present integrated device is capable of processing the relevant indices from raw measured data in real time.